Bothersome bowels – babies and beyond
Digestion is the foundation of health. The common catchphrase “you are what you eat” really should be “you are what you digest”! After all food is not fully ingested until it crosses through the lining of the digestive tract into the bloodstream and beyond. The best nutrition in the world will go to waste if it’s not properly digested.
Children especially rely on digestion to grow. From newborn to strapping lad requires a lot of nutrients, and if a child’s digestion is not right, poor nutrition can quickly follow. Not to mention discomfort, poor concentration, lack of appetite, and often severe pain.
Constipation is one of the most common complaints of babies and children. It can range anywhere from the absence of a bowel motion for a week to a daily motion but hard to pass or dry pebble like stools. It can be quite heartbreaking watching your little one in pain and struggling to pass a difficult stool. There are many solutions you can try at home, or if the problem persists you may need help from an experienced naturopath or herbalist and sometimes you may need the advice of a doctor for medication or further investigation. Each child has their own unique digestive tract with individual contributing factors. This article will offer some at home solutions that should be helpful in uncomplicated infant constipation. Try each approach for a week or so before moving on to the next.
Constipation accompanied by vomiting or blood in a stool should to be taken very seriously with an immediate visit to your child’s doctor.
What’s normal?
Newborn – 6months
Putting aside meconium and the first couple of weeks of life, a baby’s bowel motions will vary in colour and frequency greatly. Anything from light yellow to dark green is healthy and 1-5x daily can be normal. The stool should be quite soft at this stage, although formula fed babies tend to have firmer stools.
Solids onwards
Solids really change the consistency of the stool, mostly towards being more firm and formed. From this point onwards it’s ideal for children to have 1 – 3 bowel motions daily. If you are doing baby led weaning it’s common and perfectly normal to find intact pieces of food in the stool.
What can cause constipation?
Babies are born with immature digestive systems. Very quickly they cultivate healthy microflora, learn to manufacture digestive enzymes, bile and hydrochloric acid as well as perfecting peristalsis to move the food along and out of the anus. Usually this goes according to plan without a hitch but sometimes problems can occur. Whether it’s antibiotics disrupting the microflora or food intolerance slowing down digestion, each child can have different reasons for constipation.
Lets look specifically at tips for each age group.
Newborn – 6months
If your baby has gone for more than 4 days without passing a motion and seems to be in pain always talk to your midwife, plunket nurse or doctor. It is always good to rule out anything serious. If the consensus is that it’s just a sluggish bowel try some of these home remedies:
Massage
Adding 1 drop of lavender oil with 1 teaspoon of Epsom salts to a tepid bath and following with a massage can be helpful. Focus massage on the tummy area moving in a clockwise direction (the direction of the large intestine) to relieve trapped gas and encourage movement of the stool. Try this every day for a week along with some of the other suggestions. If you want to learn more about baby massage seek out the book ‘Healing massage for babies and toddlers’ by Julia Woodfield.
On the subject of movement, try the ‘over the knee’ position while rubbing baby’s back. Be sure to give them some floor time so they can stretch out the abdomen. Articulate their legs while they lie on their back, moving them gently into the tummy and around in a circular motion both ways. Make this a part of their day to encourage good digestion.
Mum’s diet
It is certainly worth considering your diet in aid of your little ones digestion. Anything dehydrating (coffee, tea, chocolate) should be avoided, while water should be greatly increased from your non nursing intake. At the same time, try adding prunes, pears and figs to your daily diet to see of this helps.
A good tip is to use the easily available breastfeeding teas even if you don’t have a milk supply issue. They commonly contain fennel, aniseed and chamomile which are all digestive carminatives and therefore helpful for constipation.
Formula
If baby is formula fed consider switching formulas to see if this helps. Sometimes the casein or lactose in dairy based formulas can disrupt digestion.
Fluids
Boiled, cooled water is the first thing to give baby directly. Depending on age and whether your child is used to a bottle, try giving anywhere from 5-50ml. Consider diluting expressed breast milk if they refuse plain water. Use a medicine syringe directly into the mouth if necessary.
If this doesn’t help, try 10-20ml of pear juice (ideally made fresh, but if you don’t have a juicer a very smooth mash is fine).
Probiotics
Often the most helpful treatment is infant specific probiotic strains. If your child has food intolerances or isn’t breastfed their flora could be out of balance. If your child was born by C-section they may also benefit from probiotics, as they miss out on getting your bacteria as they exit through the vaginal canal. This bacteria acts as a starter population for their previously sterile digestive tract.
Herbal medicine can be given to infants from birth but what to give, how to give it and how much is needed all depend on the child and situation. It is quite a specialised area requiring great care and experience, so consult with an appropriate herbalist if you would like to go down that path.
Solids onwards
After 6 months there are more options for home remedies in the form of food. If your child is constipated the first thing to do is encourage them to drink water throughout the day in addition to their breast milk or formula. All of the suggestions below need to be used with your discretion.
Prunes – try just one daily as more would be too much sugar. Often one is enough. Watch the chocking hazard.
Oats – wholegrain oats stick blended or ground in the food processor. Add 2 teaspoons of the ground oats to 1 teaspoon of ground almonds (if not allergic) and cook in 3 tablespoons of water.
Flaxseeds – ground or whole after 7 months. These will help to bulk the stool and also provide some mucilaginous lubrication to a possibly dry stool. ½ teaspoon in the above porridge mix is a good start. If using whole flaxseeds (my preference for constipation if a child has a good variety of food under their belt already) soak them for an hour or two in twice their bulk of water before adding this to food. Be sure to increase your child’s water intake while giving ground or whole flaxseeds. Do not persist with this remedy if there is no bowel motion after 3 days.
Flax seed oil – add a teaspoon to food, or expressed breast milk. If doing baby led weaning you can give straight off the spoon or syringe.
Pears – a great source of fibre and often easy to get wee ones to eat. Raw or cooked is fine.
Intolerance?
Children seem to be presenting with food intolerances more and more. A lot of mothers report constipation starting around the time of introducing solids, therefore pointing the finger at only a handful of foods. Often rice cereal is the first food, or a root vegetable of some sort. These can be harder to digest than other foods due to the starch content. This doesn’t mean your child necessarily has an intolerance. My advice is to start your child on a non-starchy vegetable such as carrot, broccoli, pumpkin or avocado. And if grainy foods such as cereals, breads and crackers have become a daily part of your child’s diet, consider replacing them with vegetables, fruits and proteins. If this sounds difficult, or if you are struggling with changing from the mainstream idea of cereal for breakfast, sandwiches for lunch etc, don’t hesitate to seek guidance as you transition. It’s important to still provide enough calories and nutrients for your growing baby. And don’t be concerned that they may never eat certain foods again. As they grow their digestive systems mature and change, and the foods they can digest often change too.
Older babies will still benefit from movement and massage, so don’t forget those basics.
As for newborns a probiotic is essential for constipation in older babies too, but if the problem is persistent keep seeking help. There are many natural medicines when used correctly, and with your child’s specific symptoms in mind, that can restore digestive balance and give your precious child some relief.
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